Neuro protocol

MS Brain MRI

Brain MRI with and without contrast specifically for multiple sclerosis evaluation. Includes sagittal FLAIR in addition to standard brain sequences, isotropic 3D T1 postcontrast with coronal and sagittal reformats for active lesion assessment.

neurobrainmultiple sclerosisMSactive lesionsFLAIRwith and without contrast

For protocol planning and internal reference only. Follow institutional MRI safety screening, contrast, dosage, and GFR policies.

Decision supportContrast GuidanceDefault contrast approach and conditional indications.

Contrast indications

Active MS lesions

Dose notes

Follow department policy regarding contrast administration and dosing.

Acquisition listSequencesRequired and conditional series for the exam.

Sequence	Plane	Phase	Required	Notes
Localizer Sagittal/Coronal/Axial	Any	noncontrast	Yes	Center at the glabella.
Sagittal STIR	sagittal	noncontrast	Yes	-
Sagittal FLAIR	sagittal	noncontrast	Yes	-
Axial T2	axial	noncontrast	Yes	-
Axial FLAIR	axial	noncontrast	Yes	-
Axial Diffusion	axial	noncontrast	Yes	Acquire DWI before other axial sequences when ruling out acute CVA.
Coronal Diffusion	coronal	noncontrast	Yes	-
Axial GRE	axial	noncontrast	Yes	-
Axial 3D T1	axial	precontrast	Yes	Isotropic 3D: slice thickness <= 1.0 mm, voxel size 1.0 x 1.0 x 1.0 mm.
Axial 3D T1 +C	axial	postcontrast	Conditional	Acquire when contrast is indicated. Coverage must include air above scalp and extend below the foramen magnum with balanced superior and inferior coverage. Reformat in coronal and sagittal planes.
Coronal and Sagittal Reformats from Axial 3D T1 +C	coronal and sagittal	postcontrast	Conditional	Reformat axial 3D T1 postcontrast images in coronal and sagittal planes.

PositioningSlice PlanningPlane-specific planning instructions and guide images for technologists.

sagittal

Sagittal planning

Cover the entire brain from left to right.
Cover from the top of the brain through the C2 level.
Cover from temporal bone to temporal bone.
Align parallel with the longitudinal fissure.
Ensure the midline slice passes through the aqueduct.

axial

Axial planning

Cover the entire brain from the top of the skull through the foramen magnum.
Align using the inferior aspect of the horns of the corpus callosum.
For Axial 3D T1 postcontrast: use isotropic 1.0 x 1.0 x 1.0 mm voxels, include air above scalp and extend below foramen magnum with balanced coverage.

coronal

Coronal planning

Cover the entire brain from anterior to posterior and side to side.
Align perpendicular to the axial slices.

coronal and sagittal

Postcontrast reformat planning

Reformat axial 3D T1 postcontrast images in coronal and sagittal planes.

Anatomic extentCoverage RulesMinimum coverage expectations and alignment rules.

sagittal

Sagittal field of view

Cover the entire brain from left to right and from the top of the brain through C2. Cover temporal bone to temporal bone.

sagittal

Sagittal alignment

Align parallel with the longitudinal fissure. Midline slice must pass through the aqueduct.

axial

Axial field of view

Cover the entire brain from the top of the skull through the foramen magnum.

axial

Axial 3D T1 postcontrast coverage

Include air above the scalp and extend below the foramen magnum with balanced superior and inferior coverage.

coronal

Coronal field of view

Cover the entire brain from anterior to posterior and side to side, perpendicular to axial slices.

TechniqueSuggested Technique SpecificationsPlane-level vendor-neutral guidance from the source protocol.

sagittal

slice thickness: <= 5.0 mm
gap: <= 2.0 mm

axial

slice thickness: <= 5.0 mm
gap: <= 2.0 mm
axial 3d slice thickness: <= 1.0 mm
axial 3d voxel size: 1.0 x 1.0 x 1.0 mm

coronal

slice thickness: <= 5.0 mm
gap: <= 2.0 mm

reformat

slice thickness: 1.0 mm
gap: 0 mm

Conditional workflowSpecial SituationsAdjustments for contrast, hardware, and protocol-specific conditions.

Contrast indicated

Add axial 3D T1 postcontrast sequence.
Reformat axial 3D T1 postcontrast images in coronal and sagittal planes.

Surgical hardware present

Remove fat saturation from the FLAIR sequence.

Uncooperative patient

Switch to the Fast Brain or Brain Blade (BLADE motion-corrected) protocol.
Acquire DWI before other axial sequences when ruling out acute CVA.

Future detailAdvancedSource-backed scanner, vendor, and site-specific notes when available.

Advanced technical details, scanner variants, and planning guide assets can appear here as protocol data expands.